The Level of FGF 21 as a New Risk Factor for the Occurrence of Cardiometabolic Disorders amongst the Psoriatic Patients.

Paulina Kiluk,Iwona Flisiak,Magdalena Maciaszek,Tomasz W Kaminski,Anna Baran

doi:10.3390/jcm8122206

Abstract

Fibroblast growth factors 21 and 23 are used as markers of cardiometabolic disorders which are common comorbidities in psoriasis. The study aimed to evaluate the serum level of these factors in psoriatic patients and elucidate the possible interplay between disease activity, metabolic or inflammatory parameters, and systemic treatment. A total of 33 patients with active plaque-type psoriasis and 11 healthy controls were enrolled in the study. Patients were divided into subgroups based on their BMI, disease severity, and treatment. Blood samples were collected at the beginning of the study and after 3 months of systemic treatment with acitretin or methotrexate. Serum FGF21 levels in psoriatic patients were higher versus control group (p < 0.05). FGF21 levels regarding psoriasis activity were significantly increased in all three subgroups compared to the controls (p < 0.05). Regarding FGF23, no significant changes were found beside positive correlation with aspartate transferase (p < 0.05). No significant effect of systemic treatment on FGF21 and FGF23 levels was found. Interestingly, a nearly threefold decrease in FGF21 concentration after acitretin-based treatment was observed (p < 0.05). After methotrexate therapy, FGF21 levels remained unchanged. FGF21 levels might be helpful in prediction of the risk of cardiometabolic comorbidities development especially in patients with severe psoriasis and obesity.

Highlights

Psoriasis is a common and chronic inflammatory skin disease whose exact pathogenesis remains uncertain and continues to be a topic of extensive research
Serum FGF21 and FGF23 levels were analyzed in 33 patients with active plaque-type psoriasis (12 women/21 men) with the mean age of 54 (24–85) and 11 healthy controls matched for age, weight, and Body mass index (BMI)
Severity of psoriasis expressed by median Psoriasis area and severity index (PASI) score was 15 (5.4–32.7) before treatment and 3.4 (0.7–15) after therapy

Summary

Introduction

Psoriasis is a common and chronic inflammatory skin disease whose exact pathogenesis remains uncertain and continues to be a topic of extensive research. Research focuses on understanding the genesis of skin lesions but especially on the explanation of systemic disorders associated with psoriasis. For years, psoriasis has been associated with an increased risk of atherosclerosis and its consequences, such as cardiovascular disease (CAD) or stroke [2,3]. Chronic inflammation is a well-established factor linking both cutaneous manifestation of the disease and the increased coexistence of the abovementioned cardiometabolic disorders. To describe this concept, the term of “psoriatic march” was introduced [5]

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